Therapy, Part 2--Food School

PJ did awesome at therapy! 

FIrst we started in the gym. Miss Heather, the speech therapist we'll be working with, said we'd start that way every week, and that she'd create a little obstacle course of sorts of PJ based on the activities in there she likes to do most. Looks like the trampoline, slide, swing, and crawl tunnel will be the main components--PJ had a blast on them all.

After that we went to the kitchen for "food school." Heather said their approach is very routine based, that we'd do the same sets of steps during food school every week to help PJ build trust in her and feel secure there. We started by blowing bubbles--another PJ fave--then played with some soap suds on the table. After cleaning the suds with wet washcloths (NOT a favorite) we set the table with plates and napkins and began the actual "work" of playing with food. :)

We started with food textures we already know she likes. Not the actual foods she's familiar with--no Cheerios or goldfish crackers--but potato straws and snap pea crisps and another similar food that I didn't get the name of--I think it had an apple-cinnamon flavor to it. We didn't just eat the food, though. Heather said that just putting the food in their mouth doesn't mean they're really processing what it is, but that by playing with it and interacting with it longer, it helps them to build a better relationship with the food. A lot of kids like PJ have very negative connotations of most foods, either because of the way they physically make them feel (like poor PJ choking on everything) or because of their strong sensory aversion to it (she said she's had kids completely freak out just by *seeing* applesauce--forget getting it anywhere near their mouths!). By getting them to play with "safe" foods, it helps segue into them playing with foods that worry them or stress them out. So we put the potato straws on our heads and "sneezed" them into metal bowls (you get a nice bell-like sound when they go in), squished the snap pea crisps with our fingers, ran the apple-cinnamon things up our arms like trains, and, of course, ate them. :) When we ate them, Heather and I did lots of exaggerated movements with out tongues to model for PJ what you're supposed to do. She doesn't get how to move food to her molars with her tongue, so we'd take a bite and then, with our mouths wide open, move it from our front teeth to our molars with big, slow tongue moves, and then do big, slow, up-and-down chewing. 

After the crunchy, "meltable" foods (foods that dissolve in your mouth eventually), we moved on to American cheese slices and dried apricot. We stuck the cheese to our cheeks (well, Heather and I did, PJ just wanted to eat it) and pushed the apricot pieces around the table like boats. These are foods PJ isn't crazy about--I was really surprised to see her eat the cheese--but they're not terrible to her. After that was squishier stuff: pieces of peach from a fruit cup, which we called fishies, and a puddle of applesauce--their pond to "swim" in. Heather showed PJ how to "fish" with a potato straw "pole" by pushing them around with it. This gave PJ a safe way to interact with food she normally wouldn't touch. She was able to push the peaches around the applesauce without getting her fingers dirty, and eventually she even ate the applesauce-covered potato straw. 

PJ did alright up until this point. But then Heather put a couple pieces of some puffy square cereal out--normally the kind of thing PJ would go for--and she got upset and stood up in the high chair. We weren't sure why. She'd been in a chair a much longer time than normal, and with her (supposedly) weak core that can get uncomfortable. Heather said it might have just been too many new things--sure it was the kind of texture and food she normally likes, but it was also the eighth food she'd seen in less than 45 minutes, and it might have just been too much. Either way, we took her out of the seat and let her sit on my lap for a few minutes. 

I had a feeling we were over at that point--once she's out of a chair, it's hard to get her back in again. But then Heather brought out a lollypop, and despite never having seen one--much less eaten one--before, it enticed PJ back into the high chair. Heather also gave her a cup of juice, and PJ immediately dipped the lollypop into it and started to "paint" the juice on the table. In the end she didn't try either one, but the interaction was good!

From there we cleaned everything up, and then had a much-deserved nursing session. We discussed our next moves here at home--today I'm going to start easing into the new nursing routine--and about the therapy in general. Heather is really amazing--she even gave me her cell phone for "feeding emergencies." :) She was really impressed with PJ's attention and interaction, so I'm praying PJ keeps it up, though she did warn me it can be a very "two steps forward, one step back" process at times, and not to get discouraged if she does great one week and then is completely uncooperative the next. Given the age PJ is, there's bound to be some resistance rooted in her burgeoning independence, and what can you do besides just roll with it? But given our first session was so positive, I'm hoping PJ continues to form a positive opinion of the whole thing and gets more and more into it. Who knows, maybe we'll be done closer to the 6 month mark!